肝段切除联合手术加胆道镜治疗肝内胆管结石  

Combination of hepatolobectomy with other operation and with biliary fibrescopy for intrahepaticolithiasis

作　　者：金晓波[1] 钟准[1] 梅祎军[1] 牟莉[1] 吴文元[1] 王长春[1] 

机构地区：[1]浙江省丽水市人民医院肝胆外科,浙江丽水323000

出　　处：《中国普通外科杂志》2004年第2期81-83,共3页China Journal of General Surgery

摘　　要：目的　探讨肝内胆管结石外科治疗的方法和效果。方法　近 12年来对 2 3 0例肝内胆管结石患者 ,根据结石的部位和肝胆系统的病理改变分别选择不同的手术 ,配合使用纤维胆道镜取石等综合措施治疗。结果　 (1)行肝段 (叶 )切除 +胆管空肠Y型吻合 10 3例 ,优良 91.8% ;(2 )行肝胆管切开取石、解除狭窄后与空肠Y型吻合 45例 ,优良 81.2 % ;(3 )行单纯胆道探查取石 +T管引流72例 ,优良 69.3 % ;(4 )行胆总管十二指肠吻合 4例及右肝段切除 +T管引流 6例。结论　对肝胆管结石患者应采用肝段 (叶 )切除联合手术或高位胆管切开取石肝胆管空肠Y型吻合手术 ,并配合术中、术后纤维胆道镜取石 ,有利于提高疗效。Objective To study the methods and effect of the surgical treatment for intrahepaticolithiasis(IHL). Methods In recent 12 years, in our hospital,230 cases of IHL were treated by different operations companied with biliary fibrescopy to remove the residnal stones of biliary tract. Results (1) Hepatolobectomy combined with Y-type hepatocholangiojejunostomy was done in 103 cases,the success rate was 91.8%.(2)Y-type hepatocholangiojejunostomy was performed on 45 cases,the success rate was 81.2%.(3)Hepaticolithotomy combined with T-tube drainage was done in 72 cases,the success rate was 69.3%. Conclusions For intrahepaticolithiasis,combination of hepatolobectomy with other operation and with biliary fibrescopy during or after the operation shoul be done, which can effectively improve the curative effect.

关 键 词：胆结石/外科学 胆管 肝内/外科学 胆道纤维镜术 

分 类 号：R657.42[医药卫生—外科学] R322.47[医药卫生—临床医学]